6210 SRO Description

Revision 17-1; Effective March 15, 2017

The Service Responsibility Option (SRO) is a service delivery option that empowers the individual to manage most day-to-day activities. This includes supervision of the individual providing personal attendant services through:

  • Community Attendant Services (CAS),
  • Family Care (FC), and
  • Primary Home Care (PHC).

The individual decides how services are provided. It leaves the business details to a provider agency of the individual's choosing. See Appendix XXXI, It's Your Choice: Deciding How to Manage Your Personal Assistance Services, for a comparison of all available service delivery option features. 

6220 SRO Roles and Responsibilities

Revision 17-1; Effective March 15, 2017

Form 1582-SRO, Service Responsibility Option Roles and Responsibilities, specifies the roles and responsibilities assigned to the individual, provider and case worker. They receive and sign Form 1582-SRO indicating their agreement to accept the SRO responsibilities. 

Appendix XXXI, It's Your Choice: Deciding How to Manage Your Personal Assistance Services, with the individual to determine if the SRO is an appropriate choice.

In addition, the case worker's responsibilities include:

  • presenting all service delivery options;

  • documenting the individual's choice on Form 1584, Consumer Participation Choice;

  • explaining SRO rights, responsibilities and resources to the individual;

  • presenting the SRO service provider list and the SRO support consultation provider to the individual;

  • presenting the list of providers that are offering the SRO;

  • making a referral to the provider(s) selected by the individual;

  • processing the individual's request to change service delivery options;

  • redeveloping the service plan when an individual's needs change;

  • serving as a resource if the individual has health or safety concerns, or worries about being taken advantage of by the attendant;

  • convening an interdisciplinary team meeting in instances where the individual:

    • has health and safety concerns,

    • is having difficulty selecting or keeping an attendant, or

    • has other issues relating to services that cannot otherwise be resolved; and

  • monitoring services in accordance with Section 6232, Monitoring. 

6222 Provider Responsibilities

Revision 17-1; Effective March 15, 2017

The provider is the attendant's employer and handles the business details (for example, paying taxes and doing the payroll). The provider also orients attendants to provider policies and standards before sending them to individuals' homes. The Service Responsibility Option (SRO) provider agency will:

  • discuss and negotiate potential back-up plans for those times when the attendant is absent from work;
  • send a maximum of three attendants, including any individuals recommended by the individual, for the individual to review;
  • explain to the selected attendants that the provider is the employer of record and that the individual is the day-to-day worker;
  • provide agency timesheets to the individual and orient the individual to the timesheet submission process, including how frequently timesheets must be completed;
  • receive and process attendant timesheets;
  • send a substitute attendant within the required time frame, ensuring that a break in services:
    • does not occur (for individuals with priority status), or
    • does not extend past 14 days (for individuals without priority status);
  • send new attendants within the required time frame to interview at the individual's request; and
  • orient the individual to the provider's attendant evaluation process, including forms and the schedule for evaluating attendants. 

6223 Individual Responsibilities

Revision 17-1; Effective March 15, 2017

The individual or designated representative (DR) is responsible for most of the day-to-day management of the attendant's activities, beginning with interviewing and selecting the person who will be the attendant. To participate in the Service Responsibility Option (SRO), the individual must be capable of performing all management tasks as described below, or may identify a DR to assist or to perform those management tasks on the individual's behalf. The individual is responsible for:

  • choosing the SRO service delivery option;
  • choosing the SRO service and support provider(s);
  • meeting with the SRO support provider within 14 days of selecting the SRO;
  • coordinating with the provider supervisor as part of the service planning process by:
    • negotiating about the type, frequency and schedule of quality assurance contacts,
    • discussing any concerns about care management,
    • requesting on-site assistance while orienting a new attendant, if desired, and
    • negotiating to develop a back-up plan for when the attendant cannot come to work;
  • selecting personal attendant(s) from candidates sent by the provider (including someone the person recommends to the provider supervisor or someone who has completed the provider pre-employment screen);
  • informing the provider supervisor within 24 hours:
    • of the personal attendant selected,
    • if the attendant gives notice,
    • if the attendant quits, or
    • if the individual wants to dismiss the attendant;
  • training the personal attendant on how to safely perform the approved tasks in the manner desired;
  • supervising the personal attendant;
  • ensuring that the attendant only does the tasks authorized in the service plan and works only the number of hours authorized in the service plan;
  • complying with provider agency payroll and attendant policies;
  • evaluating the attendant's job performance at the time designated by the provider;
  • reviewing, approving and signing provider agency employee timesheets after the attendant completes them;
  • ensuring that employee timesheets are submitted to the provider within the time frames designated by the provider;
  • notifying the provider agency as soon as possible if the personal attendant will be absent and a substitute is needed;
  • taking responsibility for liability risk if the individual or attendant is injured while doing tasks under the individual's training and supervision;
  • using the following complaint procedures:
    • If the provider is not fulfilling the expected responsibilities, address those issues directly with the agency. If the agency and the individual are not able to resolve the concerns/issues, the individual should contact the case worker.
    • If concerns and issues are still not resolved, the individual may select another provider. The individual must contact the case worker to transfer from one agency to another. The case worker will make all the necessary arrangements for the transfer;
  • notifying the case worker and/or provider supervisor of any health or safety concerns or worries about being taken advantage of by the attendant (the individual may, at any time, request an interdisciplinary team (IDT) meeting); and
  • notifying the case worker and provider supervisor if a change to either the Agency Option or Consumer Directed Services is desired. An IDT meeting will be held to plan for the change. 

6230 Casework Procedures

Revision 17-1; Effective March 15, 2017

The Service Responsibility Option (SRO) is not a different service; it is a service delivery option. All financial and non-financial eligibility criteria, including unmet need and "do not hire" policy, continue to apply for each program area. Unless otherwise stated in this section, casework procedures are not impacted by the individual's choice of SRO.

Complete all forms currently required, including the assessment of functional needs on Form 2060, Needs Assessment Questionnaire and Task/Hour Guide. Continue to identify any caregivers who are currently providing for the individual's needs. As discussed in Section 2514, Who Cannot Be Hired as the Paid Attendant, current caregivers are designated as individuals who may not be hired as paid attendants for services they are already providing. This information must be clearly explained to the individual, and the individual must be advised that the information will be relayed to the provider. 

6231 Initial Authorization of Services

Revision 17-1; Effective March 15, 2017

The individual's decision to receive services using the Service Responsibility Option (SRO) does not change the manner in which initial services are authorized. See Section 2600, Authorizing and Reassessing Services, for specific information. 

6232 Monitoring

Revision 17-1; Effective March 15, 2017

All monitoring for Service Responsibility Option (SRO) individuals is done according to the mandated schedule for their specific services (see Section 2710, Monitoring Visits and Contacts). When health and safety issues arise:

  • discuss the issues with the agency;
  • talk to the individual to determine if the issues can be resolved; and
  • if the issue cannot be resolved, convene an interdisciplinary meeting.

Because the individual now shares responsibility for service delivery, the case worker, in addition to other monitoring requirements, must monitor the individual's:

  • satisfaction with the SRO, and
  • ability to comply with SRO requirements.

If it is evident that the individual is having difficulty in the management of SRO responsibilities, the case worker will:

  • consult the provider; and
  • advise the individual of the option to transfer back to the agency service delivery option. 

6233 Procedures for Ongoing Cases

Revision 17-1; Effective March 15, 2017

Individuals will be offered the Service Responsibility Option (SRO) option annually, and may request a transfer to the SRO at any time. Additionally, the SRO must be presented to ongoing individuals at each annual reassessment or upon request. If the individual is interested in transferring to the SRO, the individual will sign Form 1582-SRO, Service Responsibility Option Roles and Responsibilities.

Ensure that the individual understands the responsibility he is assuming. Send Form 2067, Case Information, to the provider to advise it of the individual's selection. Notify the provider that that the individual will be contacting it for training. Request that the agency advise the case worker, using Form 2067, when the transition planning is complete. Negotiate a start date with the individual and the provider.